Provider Demographics
NPI:1073586806
Name:COUNTY OF POTTAWATOMIE
Entity Type:Organization
Organization Name:COUNTY OF POTTAWATOMIE
Other - Org Name:POTTAWATOMIE COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DEPARTMENT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:785-457-3719
Mailing Address - Street 1:320 MAIN ST
Mailing Address - Street 2:PO BOX 310
Mailing Address - City:WESTMORELAND
Mailing Address - State:KS
Mailing Address - Zip Code:66549-9684
Mailing Address - Country:US
Mailing Address - Phone:785-457-3719
Mailing Address - Fax:785-457-2144
Practice Address - Street 1:320 MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTMORELAND
Practice Address - State:KS
Practice Address - Zip Code:66549-9684
Practice Address - Country:US
Practice Address - Phone:785-457-3719
Practice Address - Fax:785-457-2144
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF POTTAWATOMIE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-10
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local